What are the warning signs of peripheral neuropathy? What are the four stages of peripheral neuropathy, and what are the four causes? Our Sarasota neuropathy specialists answer these questions in plain language — and explain what to do before nerve damage becomes permanent.
Peripheral neuropathy is nerve damage that usually starts in the feet and hands. The earliest warning signs are tingling, numbness and a burning sensation — especially at night. It progresses through four stages: intermittent symptoms, constant symptoms, loss of sensation, and disability. The four most common causes are diabetes, vitamin deficiencies, poor blood flow, and toxic exposure (including alcohol and some medications).
Peripheral neuropathy almost never appears suddenly. It usually begins subtly in the toes and feet — and because the early signs are easy to ignore, many people wait until nerve damage has already progressed. Here are the warning signs, starting with the ones patients notice first.
Neuropathy rarely gets better on its own — and it almost always gets worse. Nerves that are treated early have a much better chance of recovering. If you recognize even one of the early warning signs, a simple evaluation can tell you exactly what's happening.
Peripheral neuropathy is generally described in four progressive stages. Understanding which stage you're in helps determine how much nerve function can realistically be restored — and how urgent treatment is.
Symptoms come and go. You may notice occasional numbness, tingling or a slight burning sensation that fades on its own.
Most reversible at this stage
Symptoms become continuous. Pain, burning and tingling no longer come and go, and sleep is frequently disrupted.
Active nerve damage occurring
Nerve damage is significant. You may lose the ability to feel temperature or pain in the feet, and balance problems begin.
High fall and injury risk
Symptoms are disabling. Walking becomes difficult, and complications such as non-healing ulcers and infections can develop.
Treatment critical to prevent further damage
The earlier neuropathy is treated, the more nerve function can be restored. Patients in Stage 1 or 2 often see the most dramatic improvement — but even later stages benefit from treatment that slows or halts further damage.
Over 100 conditions can contribute to neuropathy, but the vast majority of cases trace back to one (or more) of these four root causes. Finding your specific cause is the key to effective, lasting treatment.
The single most common cause. Prolonged high blood sugar damages the small blood vessels that supply your nerves, cutting off the oxygen and nutrients they need to function. This is why diabetic neuropathy affects up to half of all people with diabetes.
Nerves depend on specific vitamins and nutrients to repair themselves. Deficiencies in vitamin B12, vitamin B6, folate, vitamin D and others are a common and highly treatable cause of peripheral neuropathy.
Reduced blood flow to the feet and legs starves nerves of oxygen. Circulatory problems from smoking, high blood pressure, high cholesterol or narrowed arteries are a leading contributor to neuropathy in the extremities.
Certain toxins damage nerves directly. Common culprits include heavy alcohol use, chemotherapy medications, some prescription drugs, and industrial chemicals. Toxin-related neuropathy often improves once exposure stops.
The earlier nerve damage is found, the more function can be restored. Our board-certified specialists identify the root cause of your peripheral neuropathy and build a drug-free treatment plan designed to reverse symptoms — not just mask them.
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